California Association of Neurological Surgeons Volume 43 Number 5 May 2015
INSIDE THIS ISSUE:
Georgia has figured – pages 1-2
Position Wanted - page 2
CSNS Report – pages 3-5
Brain Waves – page 6
Transitions in Neurosurgery – page 7
End of Life – page 8
Cleanliness Reduces – page 8
Simplified Multiple – pages 8-9
Medical Ethics – pages 9-10
Opinion of the Month page 11
Observation of the Month - page 11
Insight for the Month page 11
Calendar – page 12
CANS Board of Directors – page 13
Georgia has figured out a Med Mal solution that makes
MICRA obsolete
Randall W. Smith, MD, Editor
ur good friend neurosurgeon Jeff Segal, who runs Medical Justice, has penned
a good article on the pending state of Georgia Patient Compensation Act as
circulated by Medscape. The Georgia legislation would create a Patients’
Compensation System in which a patient who thinks he/she has been injured by a doc
appeals to the System to investigate (with the help of an assigned advocate). A full
record of care is reviewed by a rotating collection of medical experts in the relevant
field. If this panel agreed that (1) the doc provided care, (2) a medical injury occurred
resulting in damages and (3) that the treatment was the proximate cause of the
damages, and (4) that an accepted method of medical services was not used for
treatment or (5) that an accepted method of medical services was used for
treatment, but executed in a substandard fashion, then the case would be referred to
a compensation committee to make payment. The patient would not need a lawyer
to propel his or her case forward; however, if desired, a lawyer could help the patient
ensure that due process was followed.
The Patients' Compensation System would be a state-based entity and payments
would not be reportable to the National Practitioner Data Bank (NPDB). Physicians
would not need to purchase medical malpractice insurance, because they could not
be sued. Instead, they would pay an annual contribution to administer the program.
A family practitioner, for example, would pay $3900 per year; an orthopedic surgeon,
$15,600 per year; and a spine surgeon, $17,500 per year. The specialists with the highest
contribution rate, pediatric neurosurgeons, would pay $25,300 per year. These rates
would be significantly below the current market rate for
professional liability premiums—which typically cover only
$1 million of liability.
In the Patients' Compensation System, there is no claim to
defend. A doctor need only provide the patient's medical
record. He or she may ignore any other procedural
nuance, if desired. Alternatively, he or she may provide an
explanation of care that was rendered. And if the doctor
wants to advocate for the patient, he or she may sit with
the patient. If a doctor, for example, misses a critical
diagnosis that could have easily be made, and that error
cost the patient an extra month in the intensive care unit,
the doctor could apologize to the patient and work with
him or her in a nonadversarial setting to help the patient
achieve reasonable compensation. Furthermore, there
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California Association of Neurological Surgeons Volume 43 Number 5 May 2015
would be no depositions, no cross-examinations, and no shutting down of a practice
for 3 weeks to sit in a courtroom. Unlike the current system, there would be no reason to
deny and defend.
In the Patients' Compensation System, all complaints would be reviewed. Currently,
low-value claims are generally ignored by plaintiffs' attorneys because the cost of
prosecuting such claims exceeds the estimated recovery. In contrast, because low-
value claims would be heard under the Patients' Compensation System, more claims
would be paid; in other words, more patients would have access to justice. Payment
would be made in months rather than years, as is common now. And the amount paid
would be rational, reasonable, and predictable. Physicians would be able to speak
openly and plainly about medical errors—enabling broad patient safety initiatives to
be implemented.
The bill would also allow a three-doctor panel to report any practitioner to the state
licensing board who is an imminent danger to the public. A physician who poses such
a risk would come to the attention of the board much sooner than under the status
quo.
The Georgia bill has yet to pass the legislature and will need the governor’s signature
and will likely generate a lawsuit from attorneys. California neurosurgeons can only
dimly hope we could install such a system in the Golden state but if it goes in Georgia,
maybe it can go here.
Position wanted:
Alexa Reeves Smith, MD, is interested in joining a practice in southern
California (Ventura on south including the inland empire). Dr. Smith is a
graduate of the Med School at the University of Washington and the
neurosurgery program at UC Irvine. She recently completed a fellowship in
pediatric neurosurgery at UCSD but also would be interested in an adult
practice. Michael Levy MD, her mentor at UCSD, happy to provide a
reference ([email protected]) as well as CANS consultant Marc Vanefsky, MD
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California Association of Neurological Surgeons Volume 43 Number 5 May 2015
CSNS Report By Deborah Henry, Southwest Quadrant Secretary
r. Mark Linskey concluded his 2-year term at the helm of the Council of State
Neurosurgical Societies. In those two years of exceptional service, he had 10
initiatives including committee work advocating for strong state societies and
forming at ad hoc committee that authored 11 papers on patient safety. Forming the
California delegation to the May 1-2, 2015 CSNS meeting were Moustapha Abou-
Samra (Regional Director), acting Southwest Quadrant Chair Ken Blumenfeld (in the
absence of the injured Dr. Vanefsky), John Ratliff (QIW Chair), Pat Wade (CMA
delegate), Ripul Panchal (CMA alternate delegate), Jack Bonner (Associate editor
CANS newsletter), and myself (Southwest Quadrant secretary).
Two socio-economic abstract awards, named for prominent California neurosurgeons,
were announced. The Byron Cone Pevehouse Award went to Gabriel Zada and the
Robert Florin Award recipient was Kimon Bekelis. The Randall W. Smith Award, given for
meritorious service to the CSNS, was awarded for the third time since its inception. The
2015 recipient was Ben Rosenbaum, a neurosurgical resident at Cleveland Clinic, who
as a medical student in 2007, was tasked with creating a workable CSNS web site. He
has created and maintained this very interactive web site, complete with tool boxes
and password protected sites. The website can be viewed at csnsonline.org. The Lyal
Leibrock Award recipient was Dr. Gary Blumgarden for his endless service to the CSNS
and organized medicine. The meeting adjourned with Dr. Linskey turning over the
gavel to Dr. Ann Stroink. Wonderful job, Mark!
Randall W. Smith Award
to Benjamin Rosenbaum
Lyal Leibrock Award to Gary
Blumgarden
Seven resolutions were debated. The results were as follows:
Resolution I-2015S
Action: Adopted Substitute Resolution
Title: Gauging the Impact of hospital system mergers on the practice of neurosurgery
BE IT RESOLVED, that the CSNS study the issue of imminent changes related to economic factors
and a changing landscape of fee for service to value based medicine and develop a white
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California Association of Neurological Surgeons Volume 43 Number 5 May 2015
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paper on how neurosurgeons and neurosurgery practices can define their value in this new
environment.
BE IT FURTHER RESOLVED, that the CSNS work with the AANS and CNS to educate neurosurgeons
on how to thrive amid these ongoing changes.
Fiscal Note: $0
Resolution II -2015S
Action: Adopted Amended Resolution
Title: Creation of a AANS/CNS Safety Fellowship at the Institute for Health Care Improvement
BE IT RESOLVED, that the CSNS petition the parent organizations (AANS and CNS) to sponsor
and endorse a fellowship position within the Institute for Healthcare Improvement or any other
similar entity of the parent organization’s choosing through the AANS/CNS Quality
Improvement Workgroup (QIW); and
BE IT FURTHER RESOLVED, that the CSNS request that such fellow be chosen by the parent
organizations jointly through the AANS/CNS Quality Improvement Workgroup (QIW), with
eligibility for member neurosurgeons or residents supported by the research/elective
component year of their training program; and
BE IT FURTHER RESOLVED, that such fellowship will be continued on an ongoing basis as
determined by the AANS/CNS Quality Improvement Workgroup (QIW).
Fiscal Note: none
Resolution III 2015S
Action: Adopted Amended Resolution
Title: Creation of Joint AANS/CNS workgroup for Patient Safety
BE IT RESOLVED, that the CSNS petition the parent organizations (AANS and CNS) to create a
patient safety workgroup under the AANS/CNS Quality Improvement Workgroup (QIW), soon to
be known as the Neurosurgical Quality Council; and
BE IT FURTHER RESOLVED, that this workgroup should consist (in part) of members from the CSNS
with interest in the field of patient safety.
Fiscal Note: None
Resolution IV-2015S
Action: Rejected
Title: Programmable Shunts
BE IT RESOLVED, that manufacturers of programmable shunts provide representatives on a
routine and emergency basis to interrogate and reprogram shunts under the direction of a
neurosurgeon; and
BE IT FURTHER RESOLVED, that shunt manufacturers and neurosurgeons be encouraged to
register implanted programmable shunts with current settings into a manufacturer maintained
accessible data base; and
BE IT FURTHER RESOLVED, that the above recommendations be forwarded to the AANS and CNS
for consideration and implementation.
Fiscal Note: none
California Association of Neurological Surgeons Volume 43 Number 5 May 2015
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CANS MISSION STATEMENT
‘An organization of Neurosurgeons to promote the professional
education and scientific achievement of surgeons and quality
care for Californians’
RESOLUTION V-2015S
Action: Rejected
Title: Nominations of Future CSNS Leaders
BE IT RESOLVED, that 4 weeks prior to the spring CSNS meeting, the CSNS will send out a list of
potential CSNS qualifying member candidates to the CSNS membership; and
BE IT FURTHER RESOLVED, that the list and accompanying CVs of the potential candidates be
made available at the spring meeting for the attendants.
Fiscal Note: zero
RESOLUTION VI-2015S
Action: Adopted
Title: Surveying Stress, Burnout and Professional Pursuits among Neurosurgeons-in-Training
BE IT RESOLVED, that the CSNS will develop a survey assessing resident stressors, personal and
work environment, available mentorship, exposure to organized neurosurgery, indicators of
burnout, and assess resident professional goals; and
BE IT FURTHER RESOLVED, that the CSNS will distribute this survey and promote to all available
neurosurgical residents so that we may better assess predictors of burnout and professional
choices among the resident population effecting positive change at the training level in
clinical, academic and organized neurosurgical exposure.
RESOLUTION VII-2015S
Action: Rejected
Title: Permit Medicare Drug Price Negotiation
BE IT RESOLVED, that the Council of State Neurosurgical Societies will support all reasonable
efforts to eliminate the prohibition on Medicare drug price negotiation.
Fiscal Note: none
California Association of Neurological Surgeons Volume 43 Number 5 May 2015
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Brain Waves Deborah Henry, MD, Associate Editor
rain Waves is celebrating its five-year anniversary. In May 2010, this column started as
“Brain Waves-the meandering thoughts from a neurosurgeon.” It was relegated to the last
page and stayed there for two months with its lofty title. By July, it had moved up to the
middle of the newsletter, and its title shortened to just “Brain Waves”. December 2011 was the
only time it was the lead article, appropriately so, as it touted our upcoming Annual Meeting
and my attempts at going green and recycling New Year’s resolutions.
When I started Brain Waves, I was faculty at Loma Linda and training our future generation.
Since that time, most of those residents have graduated and moved on, the Accountable
Care Act went from conception to reality, and medical school debt has gone from 29% of
graduating medical students having debt greater than $200,000 to 43%, an increase of 14%.
One in ten medical students now owe more than $300k by the time they pick up their diploma.
Wow!
I thought long and hard prior to applying to medical school. It wasn’t the time commitment,
the long hours, blood and guts, or the fear of making a mistake that I was most worried about.
It was going into debt. I had managed to make it through college by working summers at
Anderson-Clayton foods extracting Vitamin A and B-carotene from margarine and jobs during
the school year teaching in the biology and embryology labs. I did not think working and
going to medical school would be an option. I was fortunate, however. The oil business was
still happily supplying money to the state coffers, and medical school in Texas was a bargain.
Baylor College of Medicine’s tuition was $400 (yes, that it correct) a year for my first three years.
That number did not include insurance, school fees, any living expenses, but it allowed me to
get through medical school borrowing only $25,000. I still worked the odd jobs such as cleaning
all the microscopes for $100 and delivering babies at the County Hospital during a break for $4
an hour. In a 24-hour shift, that usually amount to eight deliveries. And of course, there was the
sell your body to a clinical scientific study. I stayed away from the high-paying ones such as
the “will Toradol give you a gastric ulcer?” This one involved a pre-test endoscopy, a trial of the
NSAID or placebo and a post-trial endoscopy. Instead, I did the $100 post-doc study that
involved placing a metal object on my frontal bones at the frontal sinuses and recording
stimulation in my auditory canals. He couldn’t get the experiment to work just right and was
constantly adjusting the metal object on my forehead, enough so that after forty-five minutes
of pressure on my frontal sinuses, I was ready to pay him $100 to stop. I went through the rest of
the day with a bright ruby-red circle of erythema on my forehead.
When I first looked at practices after residency, there was a nice private practice in Austin,
Texas offering $60,000 a year (that is not a mistype). I eventually took the employed position
offering more and the ability to start operating right away. When I moved to California in 1995,
my first year’s salary in private practice was that $60,000 (again, not a mistype).
It took me less than 4 years to pay off that $25,000. I cannot even imagine how long it will take
to pay off $300,000, especially with today’s wages in private practice. It is no wonder why solo
private practice is becoming a dying field. No one can afford it.
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California Association of Neurological Surgeons Volume 43 Number 5 May 2015
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Transitions in Neurosurgery John Bonner, MD, Associate Editor
y wife and I recently went to the AANS and CSNS meetings this May in Washington, DC.
The sessions for the CSNS were very good and interesting, very supportive of
neurosurgery. Overall I agreed with the decisionmaking by the CANS delegation.
The AANS started Sunday May 3, 2015. These Sunday sessions offered practical clinics which I
assume were very good (not having taken them myself this year). The opening reception was
at the Smithsonian Museum of American History, a very crowded event. If I have any misgivings
about the opening reception, it is that it was so crowded that my wife and I hardly saw anyone
we knew. The majority of attendees were from the East Coast and Midwest.
Overall, the morning sessions were very good. Those who presented the history films were very
well accomplished and appreciated. The History Section Dinner at George Washington’s
Mount Vernon was very well attended and enjoyed. The majority of the plenary sessions were
well prepared and informative, especially that of psychiatrist and political commentator
Charles Krauthammer, M.D., as well as various neurosurgical history presentations.
However, I considered many of the afternoon presentations of neurosurgical residents and
medical students to be subpar. Unfortunately, many of these presenters were poorly prepared
and not well organized. The presentations were hurriedly given, not well understood, and, in
some cases, hard to hear. While students from previous meetings were generally well prepared,
with good presentations, I was disappointed with the student presentations at this year’s AANS
Meeting.
===
There are various neurosurgical concerns that need attention, such as Medicare overpayments
to hospitals, as noted in the April 16, 2015 Wall Street Journal. There are further neurosurgical
concerns over Obamacare. The immediate future of health costs for many state residents
across the United States hinge on the upcoming Supreme Court ruling. (Wall Street Journal,
May 20, 2015, p. A1). The Supreme Court’s ruling is also very important to medicine’s status. I
plan to review these issues in next month’s CANS Newsletter, as the Supreme Court’s ruling is
expected this June.
DO YOU KNOW A NEUROSURGEON NEW TO CALIFORNIA?
Tell them about CANS and Direct them to the CANS website:
www.cans1.org! There is a membership application on the site!
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California Association of Neurological Surgeons Volume 43 Number 5 May 2015
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Tidbits from the Editor
End of Life bill gets boost from the CMA
Following up on the editorial in last month’s newsletter, the CMA has officially declared itself
neutral on California Senate Bill 128 “ End of Life Options Act” which would allow physicians, if
they wish, to prescribe lethal amounts of medication to terminally ill patients. As with a similar
Oregon law, the California proposal would require that two independent doctors affirm that a
patient has the mental capacity to make an informed request and has less than six months to
live. The patient would have to make two verbal requests separated by at least 15 days,
followed by a written request. Only the patient would be allowed to administer the lethal drugs.
The bill’s co-authors accepted amendments requested by the CMA to more clearly state that
participation by doctors is strictly voluntary and that no doctor may be disciplined in any way
for either abiding by a terminally ill patient’s request or refusing to do so.
The bill is presently before the Senate Appropriations Committee and if passed there, goes on
to a full Senate vote. Governor Brown has yet to indicate whether or not he would sign such a
bill.
Cleanliness reduces fusion surgery infections
An article in May 2015 issue of JAMA Surgery by Serge P. Bebko, MD; David M. Green, MD and
Samir S. Awad, MD, MPH entitled Effect of a Preoperative Decontamination Protocol on Surgical
Site Infections in Patients Undergoing Elective Orthopedic Surgery With Hardware Implantation
noted that the postop infection rate in 365 patients who watched an educational video about
MRSA decontamination and were given chlorhexidine washcloths and oral rinse and nasal
povidone-iodine solution to be used the night before and the morning of scheduled surgery
experienced one-third the postop infections as compared to the 344 patients who did not
pursue the decolonization. It would seem that any practice could institute the protocol even
minus the video and potentially reap the benefits of the idea.
Simplified multiple state licensure takes a step forward
The Federation of State Medical Boards (FSMB) is an organization composed of every state
medical board plus medical boards of USA territories. The FSMB has primarily served as a place
for the various component boards to meet and greet and exchange ideas and try to spread
California Association of Neurological Surgeons Volume 43 Number 5 May 2015
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the news when a doc in one state has his/her license revoked so the other states in which the
doc is licensed can be alerted.
The average doc hasn’t received much of use from the FSMB—at least not until now. On May
19th, Alabama became the 7th state to join a FSMB sponsored Interstate Medical Licensure
Compact Commission which thus keyes the Commission to move forward. This commission will
consist of physicians, administrators, and members of the public who have been appointed to
medical boards in the participating states. It will meet later this year to discuss the
management and administration of the compact, according to the FSMB. Twenty other states
have introduced legislation that would allow their medical boards to join the Commission
(California not among them).
Under the compact, physicians who wish to practice in more than one state can be licensed in
additional states without having to fill out a formal application or provide another set of records
to each state medical board. If physicians meet the eligibility requirements spelled out in the
compact, they can have the medical board in their "principal state" attest to their
qualifications, and other states can license them. However, they must still pay the application
fees set by each state’s medical board.
This process is expected to be useful to physicians who practice in metropolitan areas that
straddle state lines. Doctors who practice telemedicine across state lines can also benefit since
much of telemedicine is defined as care occurring where the patient is and requiring the tele-
doc to be licensed there. So can locum tenens physicians who frequently move from state to
state.
Such a program would be helpful to California neurosurgeons who might want to have a 2nd
practice location in Nevada or Arizona or Oregon and sure would help those of us that do
locum tenens work. It may be a while, though, before we Californians can benefit since the
only states opting into the Commission at this point are Minnesota, Alabama, Idaho, Montana,
South Dakota, Utah, West Virginia, and Wyoming.
Medical Ethics group offers disclosure form
Scott Lederhaus, MD, neurosurgeon, CANS member and President of the Association for
Medical Ethics, based out of UC Irvine, calls our attention to a disclosure form the Association
has created. He feels that every spine surgeon should discuss the issue with every patient on
whom he/she is planning to operate and also complete the following form:
California Association of Neurological Surgeons Volume 43 Number 5 May 2015
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Disclosure of Potential Conflicts of Interest:
A conflict of interest may occur when a physician has a financial relationship with a medical
manufacturing company that could be perceived as influencing the surgeon’s choice of drugs
or devices to treat their patients. The relationship can be direct or it can be indirect through a
family member or relative. A financial interest includes being paid money by a company as an
employee, consultant, or patent holder with royalties, or being paid to promote the company’s
products such as in lectures or medical courses. Owning stock in the company is also a conflict
of interest.
Legal relationships such as these may be beneficial to advances in medicine in many cases.
Accepting money or stock from companies for the work physicians may do is not inherently
bad. The important issue for the patient is that they be made aware of the existence and
degree of financial relationships prior to treatment for the sake of transparency and patient
rights.
A Physician Owned Distributor (POD) is a company that is owned in part by the physician and
the manufacturers or other owners of a POD to buy implants. The implants are then surgically
implanted in their patients. The physician then profits by the implants used through the POD
from the sale of those implants to the hospital where the surgery occurred. If I am a participant
in a POD and I plan to use implants from a POD then I will inform the patient which implants will
be used and if I stand to make profits from such implants. I will also inform the patient if I stand
to make profits from the use of spinal implants through a consulting arrangement with any
implant company.
I ________________________________ have NO conflicts of interest and do not receive money
from any medical manufacturer.
I ________________________________ have the following conflicts of interest (Listed below):
Physician Signature: ________________________________ Date: _________________________
Patient Signature: ___________________________________ Date: _________________________
If you wish to download and print the form for your use, it is attached to the email you received
announcing this issue of the CANS newsletter.
California Association of Neurological Surgeons Volume 43 Number 5 May 2015
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Opinion for the Month: I love water. Frozen into small cubes. Surrounded by Vodka.
Observation for the Month: For the 120th straight month, the CANS
newsletter has failed to garner a Pulitzer prize.
Insight for the Month: There may be some relationship between
the Opinion and the Observation.
California Association of Neurological Surgeons Volume 43 Number 5 May 2015
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Any CANS member who is looking for a new associate/partner/PA/NP or who is looking for a position (all
California neurosurgery residents are CANS members and get this newsletter) is free to submit a 150 word
summary of a position available or of one’s qualifications for a two month posting in this newsletter. Submit your text to the CANS office by E-mail ([email protected]) or fax (916-457-8202)—Ed.
he assistance of Emily Schile and Dr. Phillip Kissel in the preparation of this newsletter is
acknowledged and appreciated.
To place a newsletter ad, contact the executive office for complete price list and details.
Comments can be sent to the editor, Randall W. Smith, M.D., at [email protected]
or to the CANS office [email protected].
Past newsletter issues are available on the CANS website at www.cans1.org.
If you do not wish to receive this newsletter in the future, please E-mail, phone or fax Emily Schile
([email protected], 916-457-2267 t, 916-457-8202 f) with the word “unsubscribe” in the subject line.
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Meetings of Interest for the next 12 months:
Rocky Mountain Neurosurgical Society: Annual Meet., June 20-24, 2015, Colorado Springs, CO
New England Neurosurgical Society: Annual Meeting, June 25-27, 2015, Chatham, MA
AANS/CNS Joint Neurotrauma and Critical Care Section Meeting, June 28, 2015, Santa Fe, NM
Western Neurosurgical Society: Annual Meeting, September 10-13, 2015, Kauai, HI
CSNS Meeting, September 25-26, 2015, New Orleans, LACA
Congress of Neurological Surgeons: Annual Meeting, September 26-30, 2015, New Orleans, LA
North American Spine Society: Annual Meeting, October 26-29, 2015, Boston, MA
California Neurology Society: Annual Meeting, November 13-15, 2015, San Francisco, CA
AANS/CNS Joint Pediatric NS Section: Ann. Meeting, December 8-11, 2015, Seattle, WA
Cervical Spine Research Society: Annual Meeting, December 3-5, 2015, San Diego, CA
North American Neuromodulation Society: Ann. Meet., December 10–13, 2015, Las Vegas, NV
CANS Annual Meeting, January 22-24, 2016, The Cliffs Resort, Pismo Beach, CA
AANS/CNS Joint Cerebrovascular Section: Annual Meeting, 2016 TBA
Southern Neurosurgical Society: Annual Meeting, March 2-5, 2016, San Antonio, TX
AANS/CNS Joint Spine Section: Annual Meeting, March 16-19, 2016, Orlando, FL
Neurosurgical Society of America: Annual Meeting, June 19-26, 2016, Dublin, Ireland
CSNS Meeting, April 29-30, 2016, Chicago, IL
AANS/CNS Joint Pain Section Bi-Annual Meeting, April 29, 2016, Chicago, IL
AANS: Annual Meeting, April 30-May 4, 2016, Chicago, IL
California Association of Neurological Surgeons Volume 43 Number 5 May 2015
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CANS Board of Directors
President Phillip Kissel, MD San Luis Obispo
President-Elect Praveen V. Mummaneni, MD San Francisco
1st Vice-Pres Kimberly A. Page, MD Redding
2nd Vice-Pres Kenneth Blumenfeld, MD San Jose
Secretary Patrick R.L. Rhoten, MD Beverly Hills
Treasurer Marshal Rosario, MD Campbell
Immed Past Pres Deborah C. Henry, MD Newport Beach
Past President Theodore Kaczmar, Jr, MD Salinas
Directors
Northern CA Ripul Panchal, DO Sacramento
John K. Ratliff, MD Stanford
Mitchel Berger, MD San Francisco
Southern CA Langston Holly, MD Los Angeles
Frank Hsu, MD UCI
Bob Carter, MD San Diego
Farbod Asgarzadie, MD Loma Linda
Consultants Moustapha Abou-Samra, MD Ventura CSNS
John T. Bonner, MD Fresno Newsletter
William L. Caton III, MD Pasadena Past President
Philipp M. Lippe, MD San Jose CAC
Lawrence M. Shuer, MD Stanford Residency Training Programs
Randall W. Smith, MD Escondido Newsletter
Patrick J. Wade, MD Glendale CMA
Kenneth Ott, MD San Diego Past President
Marc A. Vanefsky, MD Anaheim Past President
Austin R. T. Colohan, MD Loma Linda Past President
Historian Donald J. Prolo, MD San Jose
-------------------------------------------------------------------------------------
Executive Secretary Emily Schile
Editorial
Committee
Editor
Randy Smith, M.D.
Associate Editors John Bonner, M.D.
Deborah Henry, M.D.
This newsletter is published
monthly from the Executive Office:
California Association
of
Neurological Surgeons 5380 Elvas Avenue
Suite 215
Sacramento, CA 95819
Tel 916 457-2267
Fax 916 457-8202 www.cans1.org
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